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Smallpox Vaccine Logistics: Distribution, Storage, and
SecurityDepartment of Health and Human ServicesCenters for Disease Control and Prevention
December 2002
Smallpox Vaccine Logistics: Distribution, Storage, and Security
• Learning Objectives:─Describe how the smallpox vaccine will be
ordered and shipped─Describe the support to be provided by the
National Pharmaceutical Stockpile ─Describe the project area distribution and
redistribution responsibilities─Describe the storage and handling
requirements for the smallpox vaccine
National Pharmaceutical Stockpile (NPS)Concept of Operations
• Provide rapid delivery of a broad spectrum of support for an ill-defined threat in the early hours of an event
• Provide large shipments of specific materiel when a threat is known
• Provide technical assistance to receive and distribute NPS materiel during an event
NPS Response Options
• Broad Spectrum Support: ─12-Hour Push Packages
• Specific Item Support: ─Vendor Managed Inventory (VMI)─Vaccines ─Buying Power/Surge Capacity
Distribution
• We will begin shipping vaccine based on approval of State Plans
• Vaccine will be packaged at NPS Program Repositories for direct shipment to the normal distribution points within the 62 Project Areas
Distribution
• Shipments will be made on Monday, Tuesday, and Wednesday
• All shipments will be sent by commercial partners for overnight delivery
• Shipments will arrive at designated locations by 10:30 the next day
Distribution
• Stage 1 will take 14 days to complete
• All shipments will come in EnduroTherm insulated Styrofoam shipping containers
• Vaccine is a licensed product and all ancillary support will be in the kit
• Each kit provides the capability to inoculate 100 persons
• Packed by a validated protocol─Small=16 x 13 x 14 inches─Medium= 19 x 13 x 17 inches─Large= 23 x 23 x 24 inches
EnduroTherm
EnduroTherm
interior
EnduroTherm
exterior
What Do The Shipments Contain?
• Vaccine
• Diluents for vaccines that must be reconstituted (1 vial per every vial of vaccine)
• Bifurcated Needles
• Transfer Needles (1 needle for every vial of diluent)
What Do The Shipments Contain?
• Package Insert
• Lot Number Stickers
• Vaccinia Immune Globulin (VIG) will be shipped as need is validated
What Needs to be Acquired Locally
• Non-latex gloves
• 2x2 gauze pads, plus cloth tape or paper tape
• Semi-permeable bandages
What Needs to be Acquired Locally
• Zip lock plastic bags (to provide vaccinated persons with a supply of gauze pads, tape and bandages)
• Sharps containers
• Medical waste bags
• Note – Do not procure alcohol or alcohol wipes as alcohol inactivates the vaccine
Project Area Distribution Responsibilities
• Provide Points of Contact and Alternate Points of Contact for the shipment to include all telephone numbers and fax numbers• Provide the ship-to-address for the
delivery of the vaccine (no P.O. Boxes, must be a street address)• Provide estimated numbers of vaccine
doses required
Redistribution of Vaccine
• Redistribution is the responsibility of the Project Area
• “Cold Chain” must be constant during redistribution
• Temperature logging is required to validate that 2-8 degrees Celsius was maintained during movement
Redistribution of Vaccine
• Further guidance on proper “Cold Chain” management and supply practices can be obtained from the NPS Program
• Approved commercial systems available to assist in redistribution (Vaxicools and Vaxipacks)
Vaxicool
• Weighs about 110 lbs.
• Dual Temperature Settings─Holds a temperature range of 2
to 8 degrees Celsius or -17 to -20 degrees Celsius
• Uses internal battery or electrical power (115 or 230 volts)
Systems To Help With Redistribution - Vaxicool
Vaxipac
Systems To Help With Redistribution - Vaxipac
• Packed according to their existing protocol and will maintain a temperature range of 2 to 8 degrees Celsius for 24 hours• Depends solely on an inner cooler
called Vaxisafe. The Vaxisafe must be chilled (refrigerated) for at least 24 hours before being placed into a Vaxipac
Storage
• All kits must be maintained at 2-8 degrees Celsius• Proper refrigeration must be in place at
point of delivery• A temperature reading log must be
maintained on the refrigeration system• Provide details on any redistribution
plans to include “cold chain” management throughout
Security Issues
• Code of Federal Regulations must be followed
• Fixed storage facilities
• Controlled access to both the facility and the storage system
• Surveillance and/or security staff
Reminders
• Vaccine should NEVER be frozen
• Normal storage temperature is 2 to 8 degrees Celsius
• After reconstitution, vaccine:─Must be used within 30 days─Maintained at 2 to 8 degrees
Celsius
For More Information
National Pharmaceutical Stockpile
Telephone: 404-639-0459
Email: [email protected]
For More Information
• CDC Smallpox websitewww.cdc.gov/smallpox
• National Immunization Program website
www.cdc.gov/nip